Alabama is an income-cap state, and seniors who need nursing home or waiver Medicaid and earn more than $2,982/month must set up a Miller Trust before they can apply for Alabama Medicaid. Applications go directly to the Alabama Medicaid Agency, not to the county Department of Human Resources. You can apply online through a dedicated elderly and disabled portal, or by phone. This guide walks through both channels, explains the Miller Trust requirement, and covers what happens after you submit.
Before You Apply: The Miller Trust Requirement
Alabama does not have a medically needy program, which means there is no spend-down pathway for people whose income is over the limit. If your gross monthly income exceeds $2,982, you must establish a Qualified Income Trust, commonly called a Miller Trust, before submitting an application.
A Miller Trust is a legal account into which you deposit the portion of income that exceeds the cap each month. The deposited funds pay toward the cost of care, and Medicaid covers the remainder. The trust must be drafted by an attorney, funded, and active before the Alabama Medicaid Agency will approve coverage.
If you skip this step and apply while over the income cap, your application will be denied. An elder law attorney in Alabama can set up a Miller Trust in a matter of days to weeks; the Alabama State Bar's Lawyer Referral Service can connect you with one.
Who does not need a Miller Trust: Applicants whose gross monthly income falls at or below $2,982 do not need one. The trust requirement is only triggered when income exceeds the cap.
How to Apply for Alabama Medicaid Online
The Alabama Medicaid Agency runs a dedicated application portal for elderly and disabled applicants at eanddapplication.medicaid.alabama.gov. This is separate from the general Alabama Medicaid website and is where long-term care applications must be submitted online.
Steps to apply online:
- Go to eanddapplication.medicaid.alabama.gov and create an account or log in.
- Select the application type for elderly or disabled individuals.
- Complete all sections: personal information, income sources, assets, and medical need.
- Upload supporting documents directly through the portal where prompted (see the documents list below).
- Submit the application. Save or print the confirmation number.
After submitting, the Agency may contact you to schedule a phone or in-person interview. Keep your confirmation number; you'll need it if you call to follow up.
How to Apply for Alabama Medicaid by Phone
Call 1-800-362-1504 to reach the Alabama Medicaid Agency directly. A representative can walk you through the application or send a paper form to your address. If you need TTY access, use the Alabama Relay Service at 711.
Phone applications are a reasonable option if you find the online portal difficult to navigate or if you don't have reliable internet access. Have your income, asset, and identification information ready before you call.
What Documents You'll Need
Gather these before you start. Missing documents are the most common reason applications stall.
Identity and residency:
- Photo ID (driver's license, state ID, or passport)
- Social Security card
- Proof of Alabama residency (utility bill, lease agreement, or similar)
Income:
- Social Security award letter or most recent SSA-1099
- Pension or retirement income statements
- Any other income source documentation (rental income, annuity statements)
Assets:
- Bank statements for all accounts (checking and savings), typically last 3 months
- Statements for CDs, stocks, bonds, life insurance policies, and any trusts
- Property deeds and vehicle titles if applicable
- Prepaid burial contract and deed (these are generally exempt)
Medical:
- Medicare card (if applicable)
- Current health insurance information
- Documentation of medical diagnosis or level-of-care assessment if applying for nursing home or waiver coverage
Miller Trust (if applicable):
- Signed trust document
- Proof the trust account has been opened at a bank
- Bank account statement for the trust account
If a family member or authorized representative is applying on your behalf, bring documentation of that authority (power of attorney, guardianship order, or the Agency's own authorized representative form).
After You Submit: What to Expect
The Alabama Medicaid Agency reviews applications and makes eligibility determinations. Processing times vary, but the Agency is generally required to act within 45 days for most applicants and 90 days when a disability determination is needed.
What happens next:
- Document review. The Agency will review submitted materials and may request additional documentation. Respond to any request promptly to avoid delays.
- Interview. An Agency worker may contact you to conduct a phone or in-person interview to verify information.
- Level-of-care determination. For nursing facility and HCBS waiver applicants, the Agency or a contracted reviewer will assess whether your care needs meet the clinical threshold.
- Decision notice. You will receive written notice of approval or denial. An approval notice will include your coverage start date and Medicaid ID.
Check the status of your application by calling 1-800-362-1504. If you applied online, log back into the portal to check for requests or status updates.
Appeals: If Your Application Is Denied
You have the right to appeal a denial. Alabama Medicaid applicants can request a fair hearing within 30 days of the date on the denial notice.
To request a hearing, follow the instructions on your denial letter. You can also contact the Alabama Medicaid Agency at 1-800-362-1504 and ask how to initiate an appeal for your case. At the hearing, you can present evidence and argue that the denial was in error.
If you're dealing with a complex denial, particularly one involving the Miller Trust or look-back penalties, consulting an elder law attorney before the hearing deadline is worth the cost. Legal aid may be available at no charge through Legal Services Alabama for qualifying applicants.
Frequently Asked Questions
If a family member or facility social worker is handling the application, they can apply through the online portal or by phone on your behalf. A nursing home's social worker typically helps new residents start the process. Make sure any authorized representative has documentation of their authority (power of attorney or guardianship order) before contacting the Agency.
The income limit for nursing facility and HCBS waiver Medicaid is $2,982/month for a single applicant in 2026. This equals 300% of the SSI Federal Benefit Rate. Alabama does not have a spend-down program, so applicants above this threshold must use a Miller Trust to redirect the excess income and qualify.
Yes. Alabama applies a 60-month (five-year) look-back period to uncompensated asset transfers. If you gave away assets or sold property below market value within five years of applying, the Agency will calculate a penalty period during which you are ineligible for benefits. The timing and severity of the penalty depend on the amount transferred and the current penalty divisor.
Yes. The primary home is generally exempt as long as the community spouse (the spouse remaining at home) lives there. The community spouse is also protected under federal spousal impoverishment rules: they may keep up to $162,660 in countable assets (the federal maximum for 2026) and receive a Monthly Maintenance Needs Allowance to cover living expenses.
A nursing facility resident keeps $30/month for personal expenses, the federal minimum. The rest of the resident's income generally goes toward the cost of care (the "patient pay amount"), with Medicaid covering the balance owed to the facility. If the resident has a community spouse, a portion may be allocated to that spouse under the Minimum Monthly Maintenance Needs Allowance rules.
Applications for elderly and disabled Medicaid in Alabama go directly to the Alabama Medicaid Agency, not to a county office. The online portal (eanddapplication.medicaid.alabama.gov) and the 1-800-362-1504 phone line both route to the Agency.
Learn More
- Alabama Medicaid Eligibility and Income Limits
- Medicaid Planning Strategies
- Medicaid Estate Recovery Explained
Find personalized help applying for Alabama Medicaid at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.